;The Massachusetts Department of Public Health (MDPH) proposes to demonstrate the safety, security, quality and effectiveness of electronic transmission of prescriptions for federally controlled medications in the ambulatory care setting. This project will expand the adoption and diffusion of electronic prescribing, a key component of health IT and electronic health records, to improve medication management by ambulatory care clinicians at the point-of-care. Expansion of e-prescribing to cover federally controlled substances (e.g., narcotics, stimulants, sedatives) will also increase needed access to and reduce risks of dangerous pharmaceuticals, particularly for patients with chronic medical conditions who are frequently prescribed such medications. The immediate goal of the demonstration project is to foster the safe and productive adoption and diffusion of e-prescribing nationwide, through the design, implementation, evaluation and dissemination of model security standards for use by the U.S. Drug Enforcement Administration (DEA) in regulating the e-prescribing of federally controlled substances. The current lack of DEA security standards has hampered adoption of e-prescribing by ambulatory care clinicians and has resulted in a serious delay in realizing the full patient safety, clinician benefits and risk reduction that are known to result from e-prescribing, including better medication management and coordination of care, decision support, clinician workflow improvement, prevention of medication errors and reductions in non-medical use and abuse of federally controlled pharmaceuticals. MDPH will develop, implement and verify a system of safe and secure electronic transmission of prescriptions for federally controlled substances in an ambulatory care setting. Concurrently, MDPH will develop and test the interfacing of the e-prescribing system data with Massachusetts Prescription Monitoring Program data to monitor for non- medical use and abuse of federally controlled medications, while supporting enhanced patient- clinician communication, medication access and safety of patients with chronic medical conditions. Throughout the project MDPH will conduct outcomes and systems process evaluations of improvements to patient care, risk reductions, patient and clinician benefits, patient safety and information privacy and confidentiality expected to ensue from the implementation of the e-prescribing system. The project is expected to result in a system for e- prescribing of federally controlled substances that can be utilized as a model for the nation. This demonstration project will provide a model system for electronic prescribing of federally controlled medications (e.g., narcotics, stimulants, sedatives) that is safe, secure, effective and of high quality. The development and implementation of such a model is a necessary prerequisite to the widespread adoption and diffusion of e-prescribing, which promises great benefits for patient health and safety as well as clinician practice. This project has the potential to foster improvements in health care delivery in both ambulatory and non-ambulatory settings, during high risk transitions between care settings and for all populations, including vulnerable populations and particularly those with chronic medical conditions who are frequently treated with federally controlled medications.